title: Laparoscopically assisted biomaterial graft for reconstruction in congenital atresia of vagina and cervix.
abstract: OBJECTIVE
  To report successful treatment by laparoscopically assisted biomaterial graft for reconstruction in patients with congenital atresia of the uterine cervix and vagina.
  
  
  METHODS
  Technique and instrumentations.
  
  
  METHODS
  University-based tertiary care hospital.
  
  
  METHODS
  An 18-year-old woman with vaginal agenesis and cervical dysgenesis and a 13-year-old woman with vaginal agenesis and cervical agenesis, both patients with a functional uterus.
  
  
  METHODS
  Creation of a neovagina by vaginal procedure and laparoscopically assisted biomaterial graft for uterovaginal anastomosis was performed in all patients.
  
  
  METHODS
  All surgical findings were carefully reviewed to determine the anatomic characteristics of the malformed cervix. Subsequent follow-up was done by referring physicians.
  
  
  RESULTS
  Uterovaginal continuity was established successfully in both patients, and all of the women were menstruating normally. Granulomatous polyps occurred in one patient, and this condition was successfully managed. At 6-month follow-up, mean vaginal length was 12 cm and ≥ 80% of neovaginal epithelium was iodine positive in both patients. Unimpeded menstrual flow continued after 4 years of follow-up in one patient and 5 years of follow-up in the other patient.
  
  
  CONCLUSIONS
  A combined laparoscopic and vaginal procedure with biomaterial graft could be an effective alternative in selected women with atresia of cervix and vagina.
authors.affiliation: Department of Obstetrics and Gynecology, Affiliated of Beijing ChaoYang Hospital, Capital University of Medical Science, Beijing, People's Republic of China.
authors.forename: MengHui
authors.initials: M
authors.lastname: Li
authors.forename: ZhenYu
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods*; D002584:Cervix Uteri / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014621:Vagina / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
keywords: Cervical atresia; biomaterial graft; laparoscopy; uterovaginal anastomosis; vagina agenesis